A retrospective analysis on influencing factors of the prognosis of 65 elderly chronic severe hepatitis
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摘要: 目的探讨影响老年慢性重型肝炎(CSH)预后的因素。方法对65例老年CSH临床资料进行回顾性分析,根据患者预后分为死亡组与存活组,比较两组重要生化指标(ALT、TBil、PTA、ALB、TBA、Tch)、病情分期、并发症及肝硬化发病基础等。结果老年CSH以单纯HBV感染为主,死亡组总胆红素(TBil)较存活组显著升高(P<0.01),凝血酶原活动度(PTA)、白蛋白(ALB)及总胆固醇(Tch)较存活组显著降低(P<0.01,P<0.05),丙氨酸氨基转移酶(ALT)和总胆汁酸(TBA)无显著性差异(P>0.05);两组在病情分期及肝硬化发病基础均有显著性差异(P<0.01);所有患者合并至少一种并发症,两组在腹水、感染、肝性脑病(HE)、肝肾综合征(HRS)有显著性差异(P<0.05,P<0.01),但消化道出血和电解质紊乱差异无显著性(P>0.05),两组在并发症数量也有显著性差异(P<0.01)。结论HBV感染是老年CSH的主要病因,多个生化指标、凝血功能、病情分期、有无肝硬化基础及并发症均能影响老年CSH的转归,ALT、TBA...Abstract: Objective To explore the factors influencing the prognosis of elderly chronic severe hepatitis (CSH) .Methods Clinical data of 65 elderly CSH were analyzed retrospectively, cases were divided into alive group and dead group according to their prognosis, the important biochemistry parameters (ALT、TBil、PTA、ALB、TBA、Tch) , disease degree stage, complications and liver cirrhosis history of the two groups were compared.Results Simple HBV infection is main cause of elderly CSH, total bilirubin (TBil) was higher and prothombin active (PTA) , albumin (ALB) , serum total cholesterin (Tch) were lower in dead group than alive group (P<0.05, P<0.01) .There were no difference in alanine transaminase (ALT) and total bili acid (TBA) between the two groups (P>0.05) .There were significant difference in disease degree stage and liver cirrhosis history between the two groups (P<0.01) .All cases had no less than one kind complication, there were significant difference in abdominal effusion, infection, hepatic encephalopathy (HE) hepatorenal syndrome (HRS) and number of complication between the two groups (P<0.05, P<0.01) .However, there were no difference in gastrointestinal hemorrhage and disorder of electrolyte.Conclusion HBV infection is a main cause of elderly CSH, biochemistry parameters, blood coagulation function, disease degree stage, liver cirrhosis history and complications could influence survival rate of elderly CSH, the prognosis of elderly CSH had no relation to ALT and TBA.
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Key words:
- elderly /
- chronic severe hepatitis /
- prognosis /
- influencing factors /
- clinical analysis
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